Urinary Tract Infections - Dangerous for Dementia Patients

Jun 28th, 2017

Urinary Tract Infections (UTIs) are the second-most common infection a person can experience and they account for almost 25 percent of all infections in the elderly, particularly those in long term care facilities, according to the National Institutes of Health.

For young, healthy adults, the symptoms are pretty straightforward – burning with urination, frequent or intense urges to urinate and cloudy, dark or bloody urine. But for seniors, identifying the infection isn’t so simple because it often presents like symptoms of behavioral illness.

Among older adults, the presence of infection can cause significant changes in an individual’s behavior - causing them to become confused and disoriented. This confusion can produce rapid changes in the patient’s mental state such as agitation, increased difficulty concentrating, hallucinations and becoming overly sleepy or withdrawn.

UTIs can also can temporarily exacerbate the symptoms of certain mental disorders among patients already suffering from Parkinson's disease, Alzheimer's disease, or other forms of dementia.

Recognizing UTI Signs and Symptoms in Older Patients

Diagnosing UTIs in older patients can be more challenging because they don't always exhibit the hallmark sign of fever and may not be able to communicate how they feel. Among elderly patients presenting with increased signs of confusion, agitation or withdrawal, the additional presence of the following symptoms may indicate infection:

  • Burning sensations during urination
  • Frequent or intense urges to urinate
  • Pain or pressure in the back or lower abdomen
  • Cloudy, dark, bloody, or strange-smelling urine
  • Feeling tired or shaky
  • Fever or chills (a sign the infection may have reached the kidneys)

Risk Factors Unique to the Elderly

Urinary Tract Infections account for more than a third of all nursing home-associated infections, often associated with other medical factors such as:

  • Urinary catheters
  • Medical conditions, such as stroke and dementia, which can be associated with bowel and bladder incontinence
  • Dehydration from diuretic medications
  • Antibiotic resistance from prior outbreaks
  • Decreased kidney function

Prevention

Prevention is the best defense against UTIs in elderly:

  • Make sure patients urinate every two to three hours.
  • Encourage patients to drink plenty of water, especially during hot summer months when fluids can be lost through perspiration.
  • Help patients with hygiene, and ensure cleanliness in the genital area.
  • Ensure use of soap and water or commercially available cleansing wipes several times per day, and frequently change incontinence pads as they become wet. This can minimize the amount of bacteria in the urethral area.
  • Hardwire your staff’s proper cleaning and storage protocols for catheters, which are considered a common vehicle to introduce infection.

If you have questions about your elderly patient’s onset of behavioral health symptoms and have ruled out a UTI, consult with the highly-trained clinical team at Oceans Behavioral Hospital for a behavioral health assessment.  

 

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